Diseases of the Colon & Rectum

, Volume 39, Issue 10, pp 1126–1129 | Cite as

Diagnosis and outcome of isolated rectal tuberculosis

  • A. S. Puri
  • J. C. Vij
  • A. Chaudhary
  • Nirmal Kumar
  • A. Sachdev
  • V. Malhotra
  • V. K. Malik
  • S. L. Broor
Original Contributions
  • 51 Downloads

Abstract

PURPOSE: Segmental colonic tuberculosis commonly involves the ascending, transverse, or sigmoid colon. Rectal involvement in tuberculosis is uncommon and poorly characterized. This study describes the clinical presentation, endoscopic features, and outcome of isolated rectal tuberculosis. METHODS: Isolated rectal tuberculosis was defined as focal lesions of the rectum in the absence of radiologically demonstrable lesions in the small and large bowel on barium contrast studies. Diagnosis of rectal tuberculosis was based on characteristic endoscopic appearance of lesions, histopathologic features of tuberculosis in biopsy/ resected material, and response to antitubercular therapy. RESULTS: Eight patients with rectal tuberculosis were seen during a four-year period at our hospital. Hematochezia was the most common presenting feature (88 percent), followed by constitutional symptoms (75 percent) and constipation (37 percent). Rectal examination revealed a tight stricture within 10 cm of the anal verge in seven patients. Barium enema showed stricture of variable length, with focal areas of deep mucosal ulceration and increase in presacral space. Proctoscopic findings were tight stricture (7), nodularity with ulceration (6), and multiple aphthous ulcers (1). Granulomatous infiltration was detected in seven of eight patients in biopsy material obtained at endoscopy (6) or surgery (1). Cessation of hematochezia, resolution of constitutional symptoms, and weight gain were seen in all patients following treatment with antitubercular drugs. CONCLUSION: Our data suggest that tubercular involvement of rectum, although uncommon, is an important cause of rectal strictures in India. Response to antitubercular chemotherapy is uniformly good, and surgery is seldom required in these patients.

Key words

Segmental colonic tuberculosis Rectal stricture Mycobacterical infection 

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Copyright information

© American Society of Colon and Rectal Surgeons 1996

Authors and Affiliations

  • A. S. Puri
    • 1
  • J. C. Vij
    • 1
  • A. Chaudhary
    • 2
  • Nirmal Kumar
    • 1
  • A. Sachdev
    • 2
  • V. Malhotra
    • 3
  • V. K. Malik
    • 4
  • S. L. Broor
    • 1
  1. 1.Department of GastroenterologyG. B. Pant and LNJP HospitalsNew DelhiIndia
  2. 2.Department of Gastrointestinal SurgeryG. B. Pant and LNJP HospitalsNew DelhiIndia
  3. 3.Department of PathologyG. B. Pant and LNJP HospitalsNew DelhiIndia
  4. 4.Department of SurgeryG. B. Pant and LNJP HospitalsNew DelhiIndia

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